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1.
J Wound Care ; 30(Sup2): S12-S17, 2021 Feb 01.
Article in English | MEDLINE | ID: covidwho-1083226

ABSTRACT

COVID-19 is highly contagious and its rapid spread burdens the healthcare system. As the number of confirmed cases goes up, the shortage of medical resources has become a challenge. To avoid the collapse of the healthcare system during the fight with COVID-19, all healthcare workers, including wound care practitioners, should adapt to new roles and use any appropriate methods available to slow the spread of the virus. Integrating telemedicine into wound care during the outbreak helps maintain social distancing, preserve personal protective equipment and medical resources, and eliminate unnecessary exposure for both vulnerable patients and high-risk healthcare workers.


Subject(s)
Ambulatory Care , Diabetic Foot/therapy , Telemedicine , Triage , Wounds and Injuries/therapy , Cross Infection/prevention & control , Elective Surgical Procedures , Hospitalization , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control
3.
J Infect Dev Ctries ; 15(1): 58-68, 2021 Jan 31.
Article in English | MEDLINE | ID: covidwho-1079734

ABSTRACT

INTRODUCTION: SARS-CoV2 pandemic marks the need to pay attention to bacterial pathogens that can complicate the hospital stay of patients in the intensive care unit (ICU). ESKAPE bacteria which includes Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter cloacae are considered the most important, because of their close relationship with the development of ventilator-associated pneumonia (VAP). The aim of this work was to identify and characterize ESKAPE bacteria and to detect their possible clonal spread in medical devices, patients, and medical personnel of the ICU for COVID-19 patients of the Hospital Juarez de Mexico. METHODOLOGY: Genetic identification of ESKAPE bacteria was performed by analyzing the 16S rRNA gene. Resistance assays were performed according to the CLSI guidelines. Assembly of AdeABCRS operon and inhibition assays of pumps efflux in Acinetobacter baumannii isolates were performed. Associated gene involved in biofilm formation (icaA) was performed in isolates belonging to the Staphylococcus genus. Finally, typing by ERIC-PCR and characterization of mobile genetic element SCCmec were done. RESULTS: Heterogeneous distribution of ESKAPE and non-ESKAPE bacteria was detected in various medical devices, patients, and medical personnel. Acinetobacter baumannii and Staphylococcus aureus were the predominant ESKAPE members. The analysis of intergenic regions revealed an important clonal distribution of A. baumannii (AdeABCRS+). Genotyping of SCCmec mobile genetic elements and the icaA gene showed that there is no clonal distribution of S. aureus. CONCLUSIONS: Clonal spread of A. baumannii (AdeABCRS+) highlights the importance of adopting good practices for equipment disinfection, surfaces and management of COVID-19 patients.


Subject(s)
Acinetobacter Infections/transmission , Acinetobacter baumannii/isolation & purification , Cross Infection/prevention & control , Intensive Care Units , Acinetobacter baumannii/pathogenicity , Anti-Bacterial Agents/pharmacology , Biofilms/growth & development , Cross Infection/microbiology , Drug Resistance, Bacterial/genetics , Equipment and Supplies/microbiology , Genotype , Humans , Interspersed Repetitive Sequences , Mexico , Pneumonia, Ventilator-Associated/microbiology
4.
Cir Cir ; 89(1): 4-11, 2021.
Article in English | MEDLINE | ID: covidwho-1077009

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) outbreak have major implications in conventional surgical practice. As the number of patients with this diagnosis is rising, the infection risk for the surgical staff will be higher. Few publications have addressed the surgical management of patients diagnosed with COVID-19. Objective: To assess recommendations for care of patients and surgical team during the COVID-19 pandemic. Method: MEDLINE, Embase and the Cochrane Database of Systematic Reviews (April 2020) were searched the key words "COVID-19", "PROTOCOL" and "SURGERY". Relevant recommendations, guidelines and cases series were checked for the most accurate information for apply to our center. Results: We found 379 papers that included the key words. A total of 25 papers were included in the manuscript based in the pertinence of the recommendations. Three major topics were selected: perioperative, intraoperative and postoperative. Conclusion: As an attempt to regulate the surgical team approach, we present recommendations to preserve patients and surgical staff safety with high quality standards of care through reproducible strategies applicable in most hospital centers.


Subject(s)
/prevention & control , Cross Infection/prevention & control , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Pandemics , Aerosols , Air Pollution, Indoor , Appointments and Schedules , Disinfection/methods , Equipment Contamination/prevention & control , Humans , Mexico , Occupational Exposure , Operating Rooms , Patient Isolation , Perioperative Care , Personal Protective Equipment , Personnel, Hospital , Recovery Room , Sterilization/methods , Surgical Equipment
6.
Int J Mol Med ; 47(4): 1, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1067807

ABSTRACT

Nosocomial infections, also known as hospital-acquired infections, pose a serious challenge to healthcare professionals globally during the Coronavirus disease 2019 (COVID­19) pandemic. Nosocomial infection of COVID­19 directly impacts the quality of life of patients, as well as results in extra expenditure to hospitals. It has been shown that COVID­19 is more likely to transmit via close, unprotected contact with infected patients. Additionally, current preventative and containment measures tend to overlook asymptomatic individuals and superspreading events. Since the mode of transmission and real origin of COVID­19 in hospitals has not been fully elucidated yet, minimizing nosocomial infection in hospitals remains a difficult but urgent task for healthcare professionals. Healthcare professionals globally should form an alliance against nosocomial COVID­19 infections. The fight against COVID­19 may provide valuable lessons for the future prevention and control of nosocomial infections. The present review will discuss some of the key strategies to prevent and control hospital­based nosocomial COVID­19 infections.


Subject(s)
/epidemiology , Cross Infection/epidemiology , Cross Infection/prevention & control , Health Personnel , Asymptomatic Infections , China , Cross Infection/transmission , Disinfection , Hand Hygiene , Hospitals , Humans , Medical Waste Disposal , Personal Protective Equipment , Quality of Life
7.
Isr J Health Policy Res ; 10(1): 2, 2021 01 15.
Article in English | MEDLINE | ID: covidwho-1067273

ABSTRACT

Measles is a highly contagious disease. A 24 years old patient, recently exposed to measles (unvaccinated), presented in the emergency department with severe agitation, compatible with an acute psychotic episode, during the measles epidemic which spread in Israel in 2018-2019. Upon hospital admission, strict isolation was instructed, yet, without compliance, probably due to the patient's status. Measles diagnosis was promptly confirmed. As measles transmission was eminent, public health measures were employed through immediate implementation of the section 15 of the Public Health Ordinance, allowing for compulsory short-term isolation. The patient's condition improved within a few days and the measures were no longer necessary. This measles case occurred in the pre-Coronavirus disease 2019 (COVID-19) epidemic when use of a Public Health Ordinance was considered an extreme measure. This is in contrast to the current global use of Public Health laws to enforce strict quarantine and isolation on persons infected or potentially exposed to COVID-19. Nevertheless, minimizing infectious diseases transmission is a core function of public health law. Utilizing legal enforcement in circumstances of immediate public health hazard, such as nosocomial measles transmission, necessitates careful consideration. The integrative clinical and public health approach and prompt measures employed in this exceptional case, led to prevention of further infection spread.


Subject(s)
Cross Infection/prevention & control , Measles/prevention & control , Patient Isolation/legislation & jurisprudence , Public Health/legislation & jurisprudence , Acute Disease , Emergency Service, Hospital , Hospitalization , Humans , Israel/epidemiology , Male , Measles/complications , Measles/epidemiology , Psychotic Disorders/etiology , Psychotic Disorders/therapy , Young Adult
9.
Medicine (Baltimore) ; 100(5): e24503, 2021 Feb 05.
Article in English | MEDLINE | ID: covidwho-1062941

ABSTRACT

ABSTRACT: Recently, the coronavirus disease 2019 (COVID-19) epidemic has greatly threatened global public health. The responsibility of healthcare-associated infection control professionals (ICPs) is to prevent and control the nosocomial infections. The mental health status of ICPs deserves more attention, however, the correlational research is still lacking. This study aims to investigate the incidence and risk factors of mental health status among ICPs in China during the outbreak of COVID-19.A national cross-sectional survey was performed. The online questionnaire was completed by 9228 ICPs from 3776 hospitals throughout China. Data collection tools were used, including demographics data questionnaire, the Chinese version of the 12-item general health questionnaire (GHQ-12) and the Chinese version of the psychological capital questionnaire (PCQ) for medical staff. Univariate and multivariable analyses were conducted.The total score of mental health of Chinese ICPs was 3.45 ±â€Š2.57. 5608 (60.77%) ICPs might have mental health problems. The psychological capital was in the upper-middle level with an average score of 3.72 ±â€Š0.38. An increased mental health problem risk was associated with the greater self-efficacy and working in the public hospital; a significantly lower risk was obtained by working in the second-class hospital rather than in the third-class hospitals. Besides, mental health problem risk of ICPs working in hospitals of the western economic region or northeast economic region was more significant than that in hospitals of the central economic region. However, a lower risk was caused by the unmarried than married, and working years in department ≤1 year contributed to the lower risk than that >20 years. Moreover, fewer working hours per week, higher values of hope, and optimism each were contributed to a lower risk.Chinese healthcare-associated ICPs were under different levels of mental health problems in fighting against COVID-19. More importantly, we should actively deal with the mental health problem of ICPs and help them get rid of psychological disorders.


Subject(s)
Cross Infection , Infection Control Practitioners , Infection Control , Occupational Exposure , Occupational Stress , Adult , /prevention & control , China/epidemiology , Cross Infection/epidemiology , Cross Infection/prevention & control , Cross-Sectional Studies , Female , Humans , Infection Control/methods , Infection Control/organization & administration , Infection Control Practitioners/psychology , Infection Control Practitioners/statistics & numerical data , Male , Mental Health/statistics & numerical data , Occupational Exposure/prevention & control , Occupational Exposure/statistics & numerical data , Occupational Stress/epidemiology , Occupational Stress/etiology , Occupational Stress/prevention & control , Risk Assessment , Surveys and Questionnaires
10.
Curr Opin Pediatr ; 33(1): 136-143, 2021 02 01.
Article in English | MEDLINE | ID: covidwho-1054387

ABSTRACT

PURPOSE OF REVIEW: Given the limited evidence and experience with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), this novel pathogen has challenged the field of infection prevention. Despite uncertainty, infection prevention principles and experience with similar diseases have helped guide how to best protect providers and patients against disease acquisition. RECENT FINDINGS: Guidance to date has relied on data from SARS-CoV-1 and MERS-CoV to guide practices on patient isolation and personal protective equipment (PPE) use. Although a face mask and eye protection are likely adequate for most clinical scenarios, published guidelines for PPE can be confusing and conflicting. Consensus for what constitutes a high-risk aerosol-generating procedure (AGP) is lacking, but most agree providers performing procedures such as bronchoscopy, intubation, and cardiopulmonary resuscitation would likely benefit from the use of an N95 respirator and eye protection. SUMMARY: Needed research to elucidate the predominant SARS-CoV-2 mode of transmission is not likely to be completed in the immediate future. Recommendations for PPE to mitigate procedure-associated risk remain controversial. Nonetheless, implementation of existing measures based on basic infection prevention principles is likely to prevent transmission significantly.


Subject(s)
Cross Infection , Cross Infection/prevention & control , Health Personnel , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control
11.
Front Public Health ; 8: 618494, 2020.
Article in English | MEDLINE | ID: covidwho-1045482

ABSTRACT

Objective: The pandemic of coronavirus disease 2019 (COVID-19) has become a major public health challenge around the world, and outbreaks of the SARS-CoV-2 have constituted a public health emergency of international concern. Infection control measures are necessary to prevent further spread of the virus and to help control the epidemic situation. Due to the characteristics of gynecological settings, the risk of cross infection between patients and gynecologic practitioners can be high, strict and effective infection control protocols are urgently needed. This article, based on our experience and relevant guidelines and research, introduces prevention and control measures for use in gynecological outpatient clinics and provides recommended management for gynecologists in (potentially) affected areas.


Subject(s)
Ambulatory Care Facilities , Gynecology , Infection Control , Cross Infection/prevention & control , Female , Guidelines as Topic , Humans , Infection Control/organization & administration , Infection Control/standards , Public Health
12.
Int J Environ Res Public Health ; 18(3)2021 01 23.
Article in English | MEDLINE | ID: covidwho-1045425

ABSTRACT

Multidrug-resistant (MDR) organisms are emerging as some of the main healthcare problems worldwide. During the COVID-19 pandemic, several Infection Prevention and Control (IPC) measures have been adopted to reduce nosocomial microorganism transmission. We performed a case-control study to identify if the incidence of MDR bacterial infections while using pandemic-related preventive measures is lower than in previous years. From 2017 to 2020, we monitored hospital discharges over a four-month period (P #) (1 March to 30 June) in St. Andrea Hospital, Rome. In total, we reported 1617 discharges. Pearson's chi-squared test was used to identify significant differences. A value of p ≤ 0.05 was considered statistically significant. A significant reduction in the incidence of total MDR bacterial infections was observed during the pandemic compared to in prepandemic years (p < 0.05). We also found a significantly higher incidence of MDR bacterial infections in COVID-19 departments compared with other medical departments (29% and 19%, respectively), with extended-spectrum ß-lactamase Klebsiella pneumoniae as the pathogens presenting the highest increase. This study demonstrates that maintaining a high level of preventive measures could help tackle an important health problem such as that of the spread of MDR bacteria.


Subject(s)
Bacterial Infections/epidemiology , Cross Infection/epidemiology , Drug Resistance, Multiple, Bacterial , Anti-Bacterial Agents/therapeutic use , Bacterial Infections/prevention & control , Case-Control Studies , Cross Infection/prevention & control , Hospitals , Humans , Incidence , Pandemics , Retrospective Studies , Rome
14.
Healthc Q ; 23(4): 28-34, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1040175

ABSTRACT

The long-term care (LTC) sector has been the epicentre of COVID-19 in Canada. This paper describes the leadership strategies that helped manage the pandemic in one COVID-19-free LTC facility in British Columbia. Qualitative interviews with four executive leaders were collected and analyzed. The facility implemented most provincial guidelines to prevent or mitigate virus spread. Crisis leadership competencies and safety prioritization helped this site's successful management of the pandemic. There was room for improvement in communication and staffing practices and policies in the facility.


Subject(s)
/epidemiology , Cross Infection/prevention & control , Long-Term Care/organization & administration , British Columbia/epidemiology , Humans , Interviews as Topic , Leadership , Nursing Homes/organization & administration , Organizational Policy
15.
Healthc Q ; 23(4): 35-38, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1040174

ABSTRACT

With the global outbreak of the COVID-19 pandemic, hospitals in Canada and around the world have been forced to consider conservation strategies to ensure continued availability of personal protective equipment (PPE) for healthcare providers. To mitigate critical PPE shortages, Sinai Health System (Sinai Health), a large academic healthcare institution in Canada, has developed and operationalized a standard operating procedure for the collection, decontamination and reuse of N95 respirators and other single-use PPE using a vaporized hydrogen peroxide decontamination method. Sinai Health has incorporated stringent quality assurance steps to ensure that the N95 respirators are successfully decontaminated without deformation and are safe to use.


Subject(s)
Decontamination/methods , Equipment Contamination/prevention & control , Equipment Reuse , Equipment and Supplies, Hospital , /prevention & control , Cross Infection/prevention & control , Equipment Reuse/standards , Equipment and Supplies, Hospital/adverse effects , Equipment and Supplies, Hospital/standards , Equipment and Supplies, Hospital/virology , Humans , /standards , /virology
16.
Antimicrob Resist Infect Control ; 10(1): 11, 2021 01 12.
Article in English | MEDLINE | ID: covidwho-1028830

ABSTRACT

BACKGROUND: In intensive care units (ICUs) treating patients with Coronavirus disease 2019 (COVID-19) invasive ventilation poses a high risk for aerosol and droplet formation. Surface contamination of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) or bacteria can result in nosocomial transmission. METHODS: Two tertiary care COVID-19 intensive care units treating 53 patients for 870 patient days were sampled after terminal cleaning and preparation for regular use to treat non-COVID-19 patients. RESULTS: A total of 176 swabs were sampled of defined locations covering both ICUs. No SARS-CoV-2 ribonucleic acid (RNA) was detected. Gram-negative bacterial contamination was mainly linked to sinks and siphons. Skin flora was isolated from most swabbed areas and Enterococcus faecium was detected on two keyboards. CONCLUSIONS: After basic cleaning with standard disinfection measures no remaining SARS-CoV-2 RNA was detected. Bacterial contamination was low and mainly localised in sinks and siphons.


Subject(s)
Bacteria/isolation & purification , Disinfection/methods , Equipment Contamination/statistics & numerical data , Intensive Care Units/statistics & numerical data , Aerosols/analysis , Bacteria/classification , Bacteria/genetics , Bacteria/growth & development , Cross Infection/microbiology , Cross Infection/prevention & control , Cross Infection/virology , Female , Humans , Male , Middle Aged , /isolation & purification , Tertiary Healthcare/statistics & numerical data
17.
Medicine (Baltimore) ; 100(1): e24151, 2021 Jan 08.
Article in English | MEDLINE | ID: covidwho-1024162

ABSTRACT

ABSTRACT: Coronavirus disease 2019 (COVID-19) is still developing worldwide. The prognosis of the disease will become worse and mortality will be even higher when it is combined with cardiovascular disease. Furthermore, COVID-19 is highly infectious and requires strict isolation measures. For acute coronary syndromes (ACS), a common cardiovascular disease, infection may aggravate the occurrence and development of ACS, making the management of more difficult. It will be an enormous challenge for clinical practice to deal with ACS in this setting of COVID-19.Aim to reduce the mortality of ACS patients during the epidemic of COVID-19 by standardizing procedures as much as possible.Pubmed and other relevant databases were searched to retrieve articles on COVID-19 and articles on ACS management strategies during previous influenza epidemics. The data was described and synthesized to summarize the diagnosis and management strategy of ACS, the preparation of catheter laboratory, and the protection of the medical staff in the context of COVID-19. Ethical approval is not required in this study, because it is a review with no recourse to patient identifiable information.Standardized diagnosis and treatment advice can help reduce the mortality of COVID-19 patients with ACS. In the absence of contraindications, the third generation of thrombolytic drugs should be the first choice for thrombolytic treatment in the isolation ward. For patients who have to receive PCI, this article provides detailed protective measures to avoid nosocomial infection.


Subject(s)
Acute Coronary Syndrome/therapy , Acute Coronary Syndrome/virology , Cross Infection/prevention & control , Infection Control/standards , Pneumonia, Viral/epidemiology , Acute Coronary Syndrome/mortality , Humans , Pandemics , Pneumonia, Viral/virology
18.
Int J Qual Health Care ; 33(Supplement_1): 51-55, 2021 Jan 12.
Article in English | MEDLINE | ID: covidwho-1024111

ABSTRACT

BACKGROUND: In response to the coronavirus disease of 2019 (COVID-19) pandemic, healthcare systems worldwide have stepped up their infection prevention and control efforts in order to reduce the spread of the infection. Behaviours, such as hand hygiene, screening and cohorting of patients, and the appropriate use of antibiotics have long been recommended in surgery, but their implementation has often been patchy. METHODS: The current crisis presents an opportunity to learn about how to improve infection prevention and control and surveillance (IPCS) behaviours. The improvements made were mainly informal, quick and stemming from the frontline rather than originating from formal organizational structures. The adaptations made and the expertise acquired have the potential for triggering deeper learning and to create enduring improvements in the routine identification and management of infections relating to surgery. RESULTS: This paper aims to illustrate how adopting a human factors and ergonomics perspective can provide insights into how clinical work systems have been adapted and reconfigured in order to keep patients and staff safe. CONCLUSION: For achieving sustainable change in IPCS practices in surgery during COVID-19 and beyond we need to enhance organizational learning potentials.


Subject(s)
Infection Control/methods , Surgical Procedures, Operative/standards , Anti-Bacterial Agents/therapeutic use , Cross Infection/prevention & control , Epidemiological Monitoring , Ergonomics/methods , Hand Hygiene , Humans , Infection Control/standards
19.
Br J Surg ; 107(13): 1708-1712, 2020 12.
Article in English | MEDLINE | ID: covidwho-1017931

ABSTRACT

This study used a national administrative database to estimate perioperative SARS-CoV-2 infection risk, and associated mortality, relative to nosocomial transmission rates. The impact of nosocomial transmission was greatest after major emergency surgery, whereas laparoscopic surgery may be protective owing to reduced duration of hospital stay. Procedure-specific risk estimates are provided to facilitate surgical decision-making and informed consent. Estimated risks.


Subject(s)
Coronavirus Infections/epidemiology , Cross Infection/transmission , Elective Surgical Procedures/adverse effects , Infection Control/methods , Length of Stay/statistics & numerical data , Pneumonia, Viral/epidemiology , Surgical Wound Infection/mortality , Cause of Death , Coronavirus Infections/prevention & control , Cross Infection/prevention & control , Databases, Factual , Elective Surgical Procedures/methods , Emergencies , Female , Humans , Incidence , Male , Pandemics/prevention & control , Pandemics/statistics & numerical data , Pneumonia, Viral/prevention & control , Prognosis , Risk Assessment , Surgical Wound Infection/prevention & control , Survival Analysis
20.
Adv Chronic Kidney Dis ; 27(5): 383-389, 2020 09.
Article in English | MEDLINE | ID: covidwho-1019900

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2, has led to the death of hundreds of thousands of people worldwide. If infected, older individuals and those with diabetes, hypertension, cardiovascular disease, and compromised immune systems are at higher risk for unfavorable outcomes. These comorbidities are prevalent in patients with kidney disease, hence the significant burden of COVID-19 on kidney transplant programs. Multiple case series of kidney transplant recipients with COVID-19 have shown increased mortality compared to nontransplant patients. To date, we do not have high-level evidence to inform immunosuppression minimization strategies in infected transplant recipients. Most centers however have adopted early antimetabolite withdrawal in addition to other interventions. This review summarizes the published COVID-19 literature as it relates to outcomes and immunosuppression management in kidney transplant recipients. It also discusses challenges pertaining to pretransplant evaluation and wait-listed patients.


Subject(s)
/therapy , Graft Rejection/prevention & control , Immunosuppressive Agents/therapeutic use , Kidney Failure, Chronic/surgery , Kidney Transplantation , Telemedicine , /mortality , Cross Infection/prevention & control , Delivery of Health Care/methods , Deprescriptions , Humans , Immunosuppression/methods , Personal Protective Equipment , Preoperative Care , Waiting Lists
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